School-Based Health Promotion Evidence-Based Programs
The following program descriptions were compiled from various sources including
government databases (Substance Abuse & Mental Health Services Administration,
Office of Juvenile Justice and Delinquency Prevention, Department of Education), the
websites of the Collaborative for Academic, Social, and Emotional Learning, the
Prevention Research Center at Penn State, promisingpractices.net, and individual
program websites. Program information was also drawn from two books:
1) Osher, D., Dwyer, K., Jackson, S. (2003). Safe, Supportive, and Successful Schools:
Step by Step. Longmont, CO: Sopris West and 2) National Research Council and the
Institute of Medicine. (2004). Engaging Schools: Fostering High School Students'
Motivation to Learn. Committee on Increasing High School Students' Engagments and
Motivation to Learn. Board on Children, Youth, and Families, Division of Behavioral and
Social Sciences and Education. Washington, DC: The National Academies Press.
Across Ages
Across Ages pairs older adult mentors (age 55 and above) with young adolescents (ages
9-13), specifically youth making the transition to middle school. The program employs
weekly mentoring, community service, social competence training, and family activities
to build youths' sense of personal responsibility for self and community. The program
aims to: increase knowledge of health and substance abuse; improve school bonding,
academic performance, school attendance, and behavior and attitudes toward school;
strengthen relationships with adults and peers; and enhance problem-solving and
decision-making skills. The overall goal of the program is to increase the protective
factors for high-risk students in order to prevent, reduce, or delay the use of alcohol,
tobacco and other drugs and the problems associated with such use. Across Ages can be
implemented as a school-based or after-school program. It has been replicated most
successfully in urban/suburban settings where there is access to transportation and a
sufficient number of older adults not personally known or related to participating families
and youth. If the project is school-based, most of the activities for youth will take place in
the classroom; if it is an after-school program, a school, community center or faith-based
institution are appropriate settings. Evaluation data demonstrated the efficacy of the
intervention for all program youth. In particular, the research showed the effectiveness of
matching youth with older adult mentors in improving prosocial values, increasing
knowledge of the consequences of substance use, and helping youth avoid later substance
use by teaching them appropriate resistance behaviors. There was also a direct
relationship between level of mentor involvement and school attendance.
http://www.temple.edu/cil/Acrossageshome.htm
Families and Schools Together (FAST)
Families and Schools Together (FAST) is a multifamily group intervention designed to
build protective factors and reduce the risk factors associated with substance abuse and
related problem behaviors for children 4 to 12 years old and their parents. FAST
systematically applies research on family stress theory, family systems theory, social
ecological theory, and community development strategies to achieve its four goals:
enhanced family functioning, prevention of school failure, prevention of substance abuse
by the child and other family members, and reduced stress from daily life situations for
parents and children. FAST works to empower parents: entire families participate in
program activities that are designed to build parental respect in children, improve intrafamily bonds, and enhance the family-school relationship. Outreach is conducted to
individually support families, and weekly structured support group sessions form the core
of the intervention. Each program is run by a trained, culturally representative
collaborative team that implements the multifamily support groups. This team includes
representatives from: community agencies – a substance abuse professional and a mental
health professional, school staff, and parents. The middle school team also includes an
adult youth advocate, and two middle school students. Although FAST has a very
rigorous curriculum, the model also has built in options for local adaptations. Only forty
percent of the curriculum is required and cannot be changed or adapted by local sites; the
rest can be adapted to the needs of the community. Multiple rigorous evaluations tested
program outcomes goals, and each new FAST site is required to administer standardized
pre- and post-program questionnaires, overseen by the FAST National Training Center,
for local evaluation and certification. The FAST experimental studies show statistically
significant reductions in childhood aggression and anxiety and increases in academic
competence and social skills, as rated by either teachers or parents at 1- or 2-year followup.
http://www.wcer.wisc.edu/fast/
Growing Healthy
The Growing Healthy curriculum for grades K-6 addresses social, emotional, and
behavioral competencies, self-efficacy, prosocial involvement and norms, recognition for
positive behavior, and positive identity. The life skills taught in Growing Healthy include:
goal setting, decision making, creative thinking, empathy, self-awareness, problem
solving, effective communication, coping with stress, critical thinking, coping with
emotions, interpersonal relationship skills. Lessons are taught over a 1-2 year interval.
Teacher training focuses on positive change of teaching strategy, like rewarding positive
behavior. The instructional strategies utilized in Growing Healthy are those that help
students develop and practice specific life skills, and can be transferred to other subject
areas as well, thereby reaching students through a variety of experiential and participatory
learning styles across the curricula. Some of the instructional strategies utilized in Growing
Healthy include: Cooperative learning groups, role play, demonstrations, dissections, guest
speakers, brainstorming, think-pair-share, small groups, student presentations, and learning
logs. Assessments, using activities, observation, and portfolios, allow the teacher to
monitor progress and to identify student understanding over time. The Growing Healthy
program encourages parent involvement, recognizing that family involvement in education
is fundamental to children's health, strong schools, and higher levels of academic
achievement. Family members who are professionals in health related fields are
encouraged to share their knowledge about a variety of health-related topics and issues in
the Growing Healthy program. At each grade level and at each phase, letters are sent to
parents informing them of what their children will be learning. They are encouraged to
participate in the classroom, become advocates for school health education, assist with
health fairs, events, and classroom activities, model healthy behaviors, and practice healthy
communication strategies with their children. Growing Healthy utilizes opportunities to
integrate health education into other subject areas, allowing students to create, apply, and
use knowledge in many different situations. Curriculum integration demonstrates to
students the relationship among various disciplines and shows them how different subject
areas influence their lives. Interdisciplinary integration allows for ease of teaching as well.
Evaluation studies found that Growing Healthy students have significantly higher levels of
knowledge about health and how to maintain personal health compared to students who
had a traditional health curriculum. At 7th, 9th, and 11th grade, Growing Healthy students
reported significantly lower levels of experimentation with smoking or illegal drugs than
those who did not receive the curriculum. By analyzing the impact on students enrolled in
Growing Healthy K-6 with those who did not begin the curriculum until 4th grade, the
study showed that early intervention is more effective than a health education program that
begins after the primary grades. In another study, 12th grade students showed no difference
in reported behaviors when compared with students who had a traditional textbook health
curriculum in elementary school.
http://www.nche.org/growinghealthy.htm
Keep a Clear Mind (KACM)
Keep a Clear Mind (KACM) is a take-home drug education program for upper elementary
school students (8 to 12 years old) and their parents. KACM lessons are based on a social
skills training model and designed to help children develop specific skills to refuse and
avoid the use of "gateway" drugs. The take-home material consists of 4 weekly sets of
activities to be completed by parents and their children together. The program also uses
parent newsletters and incentives, such as a KACM bookmarks, bumper stickers, or
pencils. KACM requires a minimal commitment of organizational time, yet it is a costeffective way to reach parents and enhance parent-child communication about substance
use. The program can be easily facilitated by schools, youth organizations, religious
groups, and health centers. Findings generated from the evaluation of KACM activities
have considerable scientific and programmatic significance for substance use prevention
in youth. More parents who participated in the program reported that their children had an
increased ability to resist peer pressure to use alcohol, tobacco, and marijuana, had a
decreased expectation that their children would try substances, and expressed a more
realistic view of drug use and its effects on young people, compared to those in the control
group parents. Outcomes reported by children who participated included a decrease in
students’ perceptions of extensive of substance use among peers and in their expectations
that they would use tobacco, and an increase in the number of children who indicated that
their parents did not approve of the use of marijuana compared to students in the control
group.
www.keepaclearmind.com
Keepin’ It REAL
The keepin' it REAL (Refuse, Explain, Avoid, Leave) program is a video-enhanced
intervention that uses a culturally-grounded resiliency model which incorporates
traditional ethnic values and practices that protect against drug use. A school-based
prevention program for elementary, middle, and early high school students 10 through 17
years of age, keepin’ it REAL is based on previous work that demonstrates that teaching
communication and life skills can combat negative peer and other influences. keepin' it
REAL utilizes a 10-lesson classroom curriculum accompanied by a collection of five videos
produced by youths and based on actual student experiences that demonstrate resistance
strategies and illustrate the skills taught in the lessons. The program helps to teach youth
to live drug-free lives by drawing on their strengths and the strengths of their families and
communities. Students are taught how to say no to substance use through practical, easyto-remember and use strategies that are embodied in the acronym REAL (Refuse, Explain,
Avoid, Leave). Students learn how to recognize risk, value their perceptions and feelings,
and embrace their cultural values (e.g., avoiding confrontation and conflict in favor of
maintaining relationships and respect) and make choices that support them. Distinct
Mexican American, African American and multicultural versions of keepin’ it REAL were
developed so that students can recognize themselves in the prevention message and can see
solutions that are sensitive to their unique cultural environments. Worksheets, games, roleplay scenarios, and discussion materials also are used in the classroom lessons. One
monthly booster session during the 8 months after completing the classroom-based
intervention is recommended. In addition, while it is not a core component, at several
replication sites, program prevention messages and resistance strategies were reinforced in
the community through television and radio public service announcements and billboards.
Compared to control group students, keepin' it REAL students reported: better behavioral
and psychosocial outcomes, including reduction and cessation of substance use, increased
repertoire of resistance skills, more frequent use of those skills, and internalizing mediators
of substance use such as highly developed and well-articulated personal anti-drug norms.
Students also reported significantly less substance use (especially alcohol), increased
adoption of strategies to resist using alcohol, cigarettes, and marijuana, retention of
unfavorable attitudes against someone their age using substances, and perceptions that their
peers' increase in substance use experimentation was significantly less than previously
believed.
http://keepinitreal.asu.edu/
Know your Body
Know Your Body is a skills-based comprehensive health education curriculum with 49
lessons per year covering health topics such as nutrition, exercise, safety, disease
prevention, consumer health issues, dental care, HIV/AIDS, substance abuse, and violence
prevention, as well as citizenship topics. Social-emotional learning instruction is organized
around five “core skills”—self-esteem, decision making, communication, goal setting, and
stress management—with emphasis on critical thinking about advertising and other
influences on health decisions. Noteworthy instructional strategies include behavioral
contracting, self-monitoring via student journals, and frequent projects in every grade that
promote advocacy on health-related issues. School-Wide, Family, and Community
Involvement activities include sample letters for parents with every module, an activity
designed to promote interaction with parents included with most lessons, frequent use of
community members as guest speakers, and assignments and projects involving students
interacting with community members. Multiple evaluation studies document positive
behavioral outcomes, with regard to substance abuse prevention and general health
promotion, including reduced smoking at three- and five-year follow-ups and reduced
cholesterol and blood pressure at post-test and follow-up.
http://www.ed.gov/pubs/EPTW/eptw9/eptw9d.html
Life Skills Training
Dr. Botvin’s Life Skills Training is a three-year intervention designed to prevent or reduce
gateway drug use (tobacco, marijuana, alcohol) by targeting the psychosocial factors
associated with the onset of drug use. The program can be initiated in 6th or 7th grade, or,
in alternative version, with younger children (grades 3 to 5 or 4 to 6). It is designed to
provide students with the necessary skills to resist peer pressures, help them develop
greater self-esteem and self-confidence, enable children to effectively cope with social
anxiety, and increase their knowledge of the immediate consequences of substance abuse.
The program consists of classroom sessions delivered over 3 years by teachers, health
professionals, or peer leaders. Over the past 20 years, a dozen evaluation studies of Life
Skills Training have been conducted. The outcomes relative to controls included the
following: reduced alcohol use by 54% (heavy drinking by 73%) and drinking to
intoxication one or more times a week by 79%, reduced marijuana use by 71% and weekly
or more frequent use by 83%, reduced multiple drug use by 66%, reduced initiation of
cigarette smoking by 75% and pack-a-day smoking by 25%, decreased use of inhalants,
narcotics, and hallucinogens by up to 50%.
www.lifeskillstraining.com
Lions Quest
Lions Quest Skills for Adolescence is a comprehensive positive youth development and
prevention program designed for school- wide and classroom implementation in grades 5
through 8 (10 to 14 years old). It involves educators, parents, and community members to
develop essential social and emotional competencies, good citizenship skills, strong,
positive character, skills and attitudes consistent with a drug-free lifestyle, and an ethic of
service to others within a caring and consistent environment. The program has 5
components: 1) classroom curriculum: 102 skill-building classroom lessons
(implementation can vary from 9-week mini-course to 3-year program) in thematic units
and a service learning component that extends throughout the curriculum. 2) Parent
involvement: shared homework assignments, parent meetings, etc. 3) Positive school
climate: a school climate committee involving all stakeholders reinforces curriculum
themes through school-wide events. 4) Community involvement: school staff, parents,
and service organizations participate in training workshops, school climate events,
service projects, etc. and 5) Professional development: training is required for all staff
participating. The program is well researched and has shown positive benefits to student
problem-solving skills. Multiple studies document positive academic and behavioral
outcomes, and at least one study indicated positive behavioral impact at follow-up at least
one year after the intervention ended.
www.lions-quest.org
Project STAR/Midwestern Prevention Project
The Midwestern Prevention Project (MPP) is a long-term comprehensive, communitybased program for adolescent drug abuse prevention. Programming is initiated with whole
populations of middle school (sixth or seventh grade) students. The MPP strives to help
youth recognize and resist the pressures to use drugs. These skills are initially learned in
the school program and reinforced through parent, media, and community organization
components. The MPP disseminates its message through a system of well-coordinated,
community-wide strategies: mass media programming, a school program and continuing
school boosters, a parent education and organization program, community organization and
training, and local policy change regarding tobacco, alcohol, and other drugs. These
components are introduced to the community in sequence at a rate of one per year, with
the mass media component occurring throughout all the years. In the school, active social
learning techniques are learned, and homework assignments are designed to involve family
members. The parental program involves a parent-principal committee that meets to review
school drug policy, and parent-child communications training. All components involve
regular meetings of respective deliverers (e.g., community leaders for organization) to
review the programs. Evaluations of the MPP have demonstrated that program youth,
compared to control youth have reductions of up to 40 percent in daily smoking; similar
reduction in marijuana use, and smaller reductions in alcohol use maintained through grade
12 and have increased parent-child communications about drug use. Effects on daily
smoking, heavy marijuana use, and some hard drug use have been shown through early
adulthood (age 23). Further, the evaluations have demonstrated that the MPP facilitated
development of prevention programs, activities, and services in the community.
The program is not commercially available. For more information contact:
Karen Bernstein or Mary Ann Pentz, Ph.D.
USC Norris Comprehensive Cancer Center
University of Southern California
1441 Eastlake Avenue, MS-44
Los Angeles, CA 90089-9175
Phone: (323) 865-0325 or (323) 865-0330
Fax: (323) 865-0134
Email: [email protected] or [email protected]
Project Venture
Project Venture (PV) is an outdoors experiential youth development and substance abuse
prevention program designed for high-risk American Indian youth that also has been
proven successful with middle and high school-age youth from a variety of other ethnic
groups. Project Venture aims to prevent substance use and related problems through
classroom-based problem-solving activities, outdoor experiential activities, adventure
camps and treks, and community-oriented service learning. The program relies on
American Indian traditional values to help youth develop positive self-concept, effective
social skills, a community service ethic, internal locus of control, and increased decisionmaking and problem-solving skills. Program studies found that, compared to control
group, PV participants initiated first substance use at an older age significantly reduced
lifetime tobacco and alcohol use, significantly reduced frequency of tobacco and inhalant
use, demonstrate less depression and aggressive behavior, and had improved school
attendance.
http://niylp.org/programs/project_venture
Reconnecting Youth (RY)
Reconnecting Youth (RY) is a school-based prevention program for youth in grades nine
through twelve who are at risk for school dropout. These youth may also exhibit multiple
behavior problems, such as substance abuse, aggression, depression, or suicide risk
behaviors. Reconnecting Youth uses a partnership model involving peers, school
personnel, and parents to deliver interventions that address the three central program
goals: decreased drug involvement, increased school performance, and decreased
emotional distress. Four key RY components are integrated into the school environment
to accomplish these goals: 1) the RY class, offered for 50 minutes daily for one semester
(80 sessions) in a class with a low student-teacher ratio. The class focuses on self-esteem,
decision-making, personal control, and interpersonal communication. 2) School bonding
activities consisting of social, recreational, school, and weekend activities that are
designed to reconnect students to school, and health-promotion activities as alternatives
to drug involvement, loneliness, and depression. 3) Parental involvement for supporting
the skills students learn in RY Class at home. School contact is maintained through notes,
progress reports, and calls from teachers. 4) School Crisis Response planning provides
teachers and school personnel with guidelines for recognizing warning signs of suicidal
behaviors and suicide prevention approaches. Relative to controls, high-risk youth
participating in RY showed increased grades (GPA) in all classes, fewer class absences,
increased credits earned per semester, decreased high school drop-out, decreased drug
involvement, and decreased emotional distress.
http://www.son.washington.edu/departments/pch/ry/curriculum.asp
To purchase: http://www.solutiontree.com/Public/Search.aspx?ListProducts=true&Criteria1=reconnecting%20youth
Strengthening Families Program (SFP)
The Strengthening Families Program has several components: a preschool program (SFP
3-5), the original program (SFP 6-11), a program for junior high school students (SFP 1014) and an expanded teen program (SFP13-17). Two components have been extensively
evaluated and are described below: the SFP-I that involves elementary school aged children
(6 to 12 years old) and their families in family skills training sessions, and the SFP 10-14,
a video-based intervention designed to reduce adolescent substance abuse and other
problematic behaviors in youth 10 to 14 years old. SFP I uses family systems and cognitivebehavioral approaches to increase resilience and reduce risk factors for behavioral,
emotional, academic, and social problems. It builds on protective factors by improving
family relationships, improving parenting skills, and increasing the youth's social and life
skills. The SFP-I curriculum is a 14-session behavioral skills training program of 2 hours
each. Parents meet separately with two group leaders for an hour to learn to increase desired
behaviors in children by increasing attention and rewards for positive behaviors. They also
learn about clear communication, effective discipline, substance use, problem solving, and
limit setting. Children meet separately with two children's trainers for an hour, to learn how
to understand feelings, control their anger, resist peer pressure, comply with parental rules,
solve problems, and communicate effectively. Children also develop their social skills and
learn about the consequences of substance abuse. During the second hour of the session,
families engage in structured family activities, practice therapeutic child play, conduct
family meetings, learn communication skills, practice effective discipline, reinforce
positive behaviors in each other, and plan family activities together. Booster sessions and
ongoing family support groups for SFP-I graduates increase generalization and the use of
skills learned. SFP I has been evaluated numerous times. Findings include: Parent Training
improves parenting skills and children's behaviors and decreases conduct disorders;
children's Skills Training improves children's social competencies (i.e., communication,
problem solving, peer resistance, and anger control); and family Skills Training improves
family attachment, harmony, communication, and organization.
The SPF 10-14 program is delivered within parent, youth, and family sessions using
narrated videos that portray typical youth and parent situations. Sessions are highly
interactive and include role-playing, discussions, learning games, and family projects
designed to improve parenting skills, build life skills in youth, and strengthen family bonds.
The basic program is delivered over 7 weeks, usually in the evenings. Four optional booster
sessions can to be held 3 to 12 months after the basic sessions. The program is not
necessarily school-based. A large-scale evaluation showed that parent participants showed
significantly improved parenting behaviors, and youth showed statistically significant
delays in initiation of alcohol, tobacco, and marijuana use compared to controls. The
positive results actually increased over the 6 years of follow-up assessment, compared to
the controls. Specific results (compared to a control group) among youth include: 30%60% reduction in substance use at 4-year follow-up (depending on the substance); 32%77% reduction in conduct problems at 4-year follow-up (depending on the behavior);
increased resistance to peer pressure; and delayed onset of problematic behaviors.
http://www.strengtheningfamiliesprogram.org/index.html
Teen Outreach Program
The Teen Outreach Program (TOP) is a broad, developmental intervention that attempts to
help teens (12-17) understand and evaluate their life options. The program is designed to
prevent problem behaviors in adolescents and increase academic achievement. The TOP
program is made up of classroom-based and community-based volunteer components.
Either trained classroom teachers or guidance personnel act as facilitators in implementing
the TOP classroom curriculum, “Changing Scenes.” The curriculum involves very little
programming directed specifically to the targeted behaviors (pregnancy prevention, etc.)
Its focus is twofold: (1) to help students prepare for their real-world volunteer experiences
through fostering self-esteem, confidence, social skills, decision-making, and discipline;
and (2) personal and social developmental growth and guidance through an exploration of
personal and life values, understanding oneself and others, building life-skills, mechanisms
for coping with stress, communication skills, and the transition to adulthood. The
curriculum utilizes a combination of traditional classroom methods (such as lectures or
presentations) in addition to small-group discussions and role-playing. Students are
encouraged to share their experiences. In addition, participants are required to participate
in a minimum of 20 hours per year of community-based volunteer service. The volunteer
component helps students to take on adult roles and build personal responsibility. Students
are permitted to choose from a wide range of volunteer activities, depending on their skills,
the needs of their community, and site availability. Historically, the program was schoolbased and was offered most frequently during school hours as part of a health education
curriculum or other core course programs. More recently, the program has expanded to
numerous after-school and community-based settings. While the particulars of the formats
may vary among the different sites, all program sessions meet at least once a week during
the full academic year. An evaluation of the TOPS program for high-school aged students
found that after program completion suspension rates, course failure rates, and pregnancy
rates decreased compared to controls. Despite positive outcomes, the program evaluation
had a number of methodological limitations that call into question how generalizable and
conclusive the results may be. In particular, despite random assignment to treatment status
and fairly good matching of socio-demographic characteristics, the treatment and control
groups differed significantly at entry on all measures of problem behaviors. At initial data
collection, the control group showed higher levels of prior course failure, suspension, and
pregnancy. Although an attempt was made to control for these differences in the analyses,
these discrepancies could suggest that the TOP group was “better off” from the start and
may have been predisposed toward more favorable outcomes.
http://www.wymanteens.org/teenoutreach.htm